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At one time humans obtained most of their calories from food. That changed with the arrival of cheap sugar, and then cheaper high-fructose corn syrup.

In the late 16th century, a teaspoon of sugar cost the equivalent of ten pounds in London (1). Nowadays, 1 teaspoon of sugar costs approximately one pence (2).

Sugar added to food now accounts for nearly 16 percent of the average American’s daily intake; sweetened soft drinks make up nearly half of that (3).

In Britain, government statistics indicate that 14.2 per cent of the calories in the average diet come from added sugars (4).

Researchers at Glasgow University asked 2,005 people from across the UK to estimate how many teaspoons of sugar were in some of the UK’s most popular drinks (5). Those surveyed were also asked to estimate their average weekly liquid consumption in detail.

The findings suggest that the average person in the UK consumes 659 grams of sugar and 3,144 calories per week (which equates to 450 calories per day) through non-alcoholic liquid intake. This is the equivalent of nearly a quarter of recommended daily calories for a woman and a fifth for men.

People underestimated the amount of sugar in a serving of pomegranate juice by an average of 17.9 teaspoons, while they overestimated the amount of sugar in a serving of fruit squash by almost seven teaspoons.

It is worth noting that a number of products state they contain “100% juice” or “100% pomegranate juice”. You need to read the product label carefully because most products contain only 20 to 30 per cent pomegranate, with the rest typically apple or grape juice.

Pomegranate juice

Professor Naveed Sattar said:

“While people sometimes overestimate the amount of sugar in carbonated drinks, they significantly underestimate the sugar levels in smoothies and fruit juices.

This analysis confirms that many people are perhaps not aware of the high calorie levels in many commonly consumed drinks. Some varieties of drinks such as pure fruit juices and smoothies which are perceived as “healthy” options are also very high in sugar. For many people struggling with their weight, reducing their intake of such drinks and replacing with water or diet drinks would be a sensible first target to help them lessen their calorie intake.

For some, this change might seem difficult or impossible as they admit to having a “sweet tooth.” However, it is now clear that our taste buds can be retrained over time to enjoy far less sugar in drinks (or no sugar at all). But people deserve support and encouragement to make these changes and the soft drinks industry also has a role to play here by providing drinks with less sugar or offering cheaper diet versions.”

According to information from the British Soft Drinks Association, most soft drinks do not contain sugar. Their data indicate that more than 60 per cent of the soft drinks market is now made up of diet, low calorie and no added sugar drinks, up from 30 per cent 20 years ago (6).

Thin friends who eat a lot could put your waistline at risk, according to a new study in the Journal of Consumer Research, which examines how other peoples’ weight and food choices influence how much we eat.

“We decided to investigate how someone’s size and food choices could influence how much the people around them eat.”

Researchers recruited 210 college students to participate in a study that was ostensibly about movie watching. The participants were told they would be paired with another student taking part in the study. The other student was actually a member of the research team whose natural build was thin (size 0, 105 pounds). But at times this same researcher donned an “obesity prosthesis,” which made her appear to be a size 16 and 180 pounds.

All of the students were offered snacks while viewing film clips. The undercover researcher was served first, and helped herself to either a large or small serving before the student participant was offered the same bowl of food. In all cases, the amount of food the students accepted was influenced by the portion size chosen by the undercover researcher, regardless of her size.

“Most participants took a portion similar to what the researcher served herself,” the authors explain. “However, it is clear that how much food each person took, and how much they ate depended on whether their companion was thin or obese.”

Participants tended to mimic the thin companion’s portion sizes. But when they presumed the researcher to be obese, the participants adjusted the amounts they ate.

“This indicates that people are influenced, even without being aware of it, by other people’s portion choices,” the authors write.

“Our findings indicate that the size of the person you dine with matters much less than the size of the meal they order,” the authors write. “If a heavy-set colleague eats a lot, you are likely to adjust your behaviour and eat less. But a thin friend who eats a lot may lead you to eat more than you normally would.”

This week, the British Soft Drinks Association published the 2009 UK Soft Drinks Report. Despite the recession and the wet summer, total soft drink consumption held up, with a 1 per cent increase in market value, although volume declined by 1 per cent. Bottled waters and smoothies were particularly hit by a decline in volume, whilst carbonated drinks, still and juice drinks increased in volume. Consumers’ focus on health and wellbeing, and a desire for naturalness benefited the not from concentrate (NFC) fruit juice category with volumes up 10 million litres so that NFC juice now represents over 45% of the chilled juice segment. The overall retail value of fruit juice did, however, decline in 2008 (down 4% to £1900 million). In total, £13 billion was spent on soft drinks in the UK, representing consumption of 13905 million litres. This is an average of 4.4 litres per person per week, or the equivalent of 2 cans per person per day.

Consumption of soft drinks is continuing to rise. Findings from the last UK National Diet and Nutrition Survey showed that consumption of soft drinks in adults in 2000/01 was equivalent to 4-5 cans per week, compared to less than 3 cans per week in 1986/87. The majority of soft drinks consumed were carbonated. Statistics from the British Soft Drinks Association show that 60 per cent of the carbonated drinks consumed are low-calorie and no added sugar types. In 2000/01 young men and women (19-24 years) consumed over three times the quantity of soft drinks as did the oldest men and women (50-64 years).

Evidence from the British Soft Drinks Association suggests that children drink an average of 4.7 litres of soft drink per week, of which only 10% are fruit juice or water.

According to the last National Diet and Nutrition Survey in the UK, soft drinks (mainly carbonated) were the single largest contributor to non-milk extrinsic sugars (NMES) intake in all age groups, providing a quarter to a third of intake on average.

It is interesting to note that groups with the lowest mean intakes and biochemical status of almost all nutrients had the highest consumption of soft drinks.

Although the British Soft Drinks Association denies a link between soft drink consumption and obesity, pointing instead to the value of soft drinks for encouraging adequate hydration, there can be little doubt that these rivers of sugar are doing little to enhance the health of the nation.

Each 330 ml can of sugary drink or juice typically has 10 to 12 teaspoons of sugar, and 150 or more calories. Is it pure coincidence that the rising thirst for sugar-water has paralleled the epidemic rise of obesity and type 2 diabetes? There is now strong evidence that sugary drinks have contributed substantially to the rapid growth of “diabesity”. Women who have one or more servings of a sugary drink per day have nearly double the diabetes risk of women who rarely have sugary drinks.

Latest research from the Harvard School of Public Health finds disturbing evidence of a link between sugary drink consumption and heart disease. The study, published in the April edition of the American Journal of Clinical Nutrition, followed the health of nearly 90,000 women over two decades. It found that women who drank more than 2 servings of sugary beverage each day had a nearly 40 percent higher risk of heart disease than women who rarely drank sugary beverages.

Water, of course, is the best beverage option. It delivers everything the body needs – pure H2O – with zero calories. But for some tastes, ordinary water is just too dull and it is unrealistic to expect people to overcome their sugar-water addiction overnight. Instead, it will require concerted effort at a range of levels to retrain our palates. We need to educate individual consumers about the benefits of consuming less sugary drinks, provide healthier alternatives in schools and worksites, and encourage creativity and innovation among food scientists and marketers in the beverage industry to develop products that consider health and well-being whilst maintaining profitability.

For further information about the effects of drinks on our health, please come to a Cooking for Health Course, led by Nutrition Consultant Jane Philpott, MA (Oxon), MSc, PhD.

While the energy density of soft drinks, which are frequently highly calorific, needs to be considered differently from that of solid foods, recent research has demonstrated that consumption of soft drinks is likely to increase normal caloric intake. When people consume soft drinks, they do not recognise that they have taken in extra energy and compensate by reducing energy from elsewhere in their daily diet, or by expending additional energy; they simply add it on.

A standard 330 ml can of Coca-Cola contains 139 calories. Thus if a person were to consume a can of Coca-Cola with two meals per day, over a week that would result in an energy surplus of nearly 2,000 calories-more than a whole day’s recommended calorie intake for the average woman, and about three-quarters of the recommended daily calorie intake for a man. Evidence from the British Soft Drinks Association suggests that children drink an average of 4.7 litres of soft drink per week, of which only 10% are fruit juice or water.

Consumption of alcohol, particularly amongst women and young people in the UK, has increased dramatically during the past years. Since 1970, alcohol consumption in the UK has increased by 40 per cent. With most alcoholic drinks being at least as calorific as a high-sugar soft drink, such as Coca-Cola, it would seem intuitive that the massive increase in their consumption has had some impact on the nation’s weight. Much attention has focused in recent months on the growing culture of ‘binge drinking’, particularly amongst young people. While the health risks associated with this are well documented, what is less publicised is that drinking five pints of lager over an evening adds an extra 1,135 calories, nearly half a man’s daily energy requirement, and five bottles of an ‘alcopop’ such as Bacardi Breezer contain 990 calories, nearly half a woman’s daily energy requirement.

Researchers from the Johns Hopkins Bloomberg School of Public Health examined the relationship between beverage consumption among adults and weight change and found that weight loss was positively associated with a reduction in liquid calorie consumption and liquid calorie intake had a stronger impact on weight than solid calorie intake. The results are published in the April 1, 2009, issue of the American Journal of Clinical Nutrition.

“Both liquid and solid calories were associated with weight change, however, only a reduction in liquid calorie intake was shown to significantly affect weight loss during the 6-month follow up,” said Benjamin Caballero MD, PhD, senior author of the study and a professor with the Bloomberg School’s Department of International Health. “A reduction in liquid calorie intake was associated with a weight loss of 0.25 kg at 6 months and 0.24 kg at 18 months. Among sugar-sweetened beverages, a reduction of 1 serving was associated with a weight loss of 0.5 kg at 6 months and 0.7 kg at 18 months. Of the seven types of beverages examined, sugar-sweetened beverages were the only beverages significantly associated with weight change.”

Researchers conducted a prospective study of 810 adults aged 25-79 years old participating in the PREMIER trial, an 18-month randomized, controlled, behavioural intervention. Caballero along with colleagues from the Johns Hopkins School of Medicine; the National Heart, Lung, and Blood institute; Duke University; the Pennington Biomedical Research Center; the Kaiser Permanente Center for Health Research; the University of Alabama; and Pennsylvania State University measured participant’s weight and height using a calibrated scale and a wall-mounted stadiometer at both 6 and 18 months. Dietary intake was measured by conducting unannounced 24-hour dietary recall interviews by telephone.

Researchers divided beverages into several categories based on calorie content and nutritional composition:

They found that at 37 percent sugar-sweetened beverages were the leading source of liquid calories.

Consumption of liquid calories from beverages has increased in parallel with the obesity epidemic.

Earlier studies by Bloomberg School researchers project that 75 percent of U.S. adults could be overweight or obese by 2015 and have linked the consumption of sugar-sweetened beverages to the obesity epidemic, which affects two-thirds of adults and increases the risk for adverse health conditions such as type 2 diabetes.

“Among beverages, sugar-sweetened beverages was the only beverage type significantly associated with weight change at both the 6- and 18-month follow up periods,” said Liwei Chen, MD, PhD, MHS, lead author of the study and a Bloomberg School graduate. “Changes in the consumption of diet drinks and alcoholic beverages were inversely associated with weight loss, but were not statistically significant. Our study supports policy recommendations and public health efforts to reduce intakes of liquid calories, particularly from sugar-sweetened beverages, in the general population.”

In the UK, little government attention seems to be given to the impact of soft drink and alcohol consumption on obesity. The adverse health effects of excess alcohol consumption are well-documented but its effects on weight gain are underestimated. The effect of alcohol on obesity is not even mentioned in the Chief Medical Officer’s recent Annual Public Health Report, which created controversy by suggesting a range of measures to address the nation’s drink problem.

“Easy access to cheap alcohol is “killing us as never before” and must be curbed with tough licensing laws, price rises and a shift in public opinion that makes being drunk as unacceptable as smoking”.

Responding to comments from Downing Street that the majority of sensible drinkers should not have to pay for the excessive drinking of the minority, Sir Liam said: “I take a different view as to whether heavy drinking is a minor and insignificant problem.”

If the UK government is not yet prepared to tackle the well-understood health problems associated with alcohol consumption, we clearly have a long way to go before its effect on obesity reaches the radar screen.

For information on the effects of different types of drinks on health and creative ideas for healthy drinks, please come to a Cooking for Health course, held throughout the year in Somerset, UK, led by nutrition expert Dr Jane Philpott.

Overweight and obesity among children is widely regarded as being even more serious than it is among adults, with a very rapid rise in prevalence in the last two decades. Child obesity is likely to continue into adulthood, and many of the problems linked to obesity are more severe if the obesity has been present for a long period. Adults with the highest risk of diabetes, cardiovascular disorders, liver malfunction and orthopaedic dysfunction, are likely to have the most extreme levels of obesity and to have been obese since childhood[i].

Projections of child obesity based on trends from the 1980s and 1990s indicate that the annual increase in child obesity prevalence is itself increasing[ii]. By the year 2010, some 26 million school children in the EU are expected to be overweight, of which 6 million will be obese. The numbers of overweight children will rise by some 1.3 million per year, of which the numbers of obese children will rise by over 0.3 million per year.

At a conservative estimate, over a million obese children in the EU are likely to show a range of indicators for cardiovascular disease, including high blood pressure and raised blood cholesterol levels, and to have three or more indicators of the metabolic syndrome[iii]. Over 1.4 million children could have early stages of liver disorder.

The costs of childhood obesity have not been estimated but should include lost educational opportunity. A study of children’s quality of life found the psychological effects of severe obesity to be equivalent to a diagnosis of cancer[iv].

Behaviour, learning and mental health problems in children are rising as fast as rates of obesity and diabetes. Food affects brains as well as bodies, and early malnourishment can have devastating effects on both. Conversely, improving nutrition can help reduce antisocial behaviour as well as symptoms of ADHD, dyslexia, depression and related conditions[v].

The only pan-European estimates of children’s food consumption patterns are from self-reported surveys of health behaviours of children aged 11-15 years[vi]. The most recent (for 2001-2002) found:

In virtually all countries fewer than 50 per cent of children ate vegetables every day. On average, 30 per cent of children said they ate vegetables daily, but the children in countries once famous for their Mediterranean diets reported lower than average levels, especially Spain, where vegetables were typically eaten daily by only 12 per cent of children.

In virtually all countries fewer than 50 per cent of children ate fruit every day. On average, 30 per cent of boys and 37 per cent of girls reported eating fruit daily, but in sixteen countries only 25 per cent of children were eating fruit more than once a week. Lowest levels of consumption were reported among children in Northern European countries.

Soft drinks and confectionery were consumed daily by about 30 per cent of children (over 40 per cent in some countries).

According to the last National Diet and Nutrition Survey in the UK[vii]:

92 per cent of children consume more saturated fat than is recommended

86 per cent consume too much sugar

72 per cent consume too much salt

96 per cent do not consume enough fruit and vegetables

Governments are trying to improve children’s diets, but young people’s exposure to marketing pressures in our time-poor, anxiety-ridden, media-driven society is at an all-time high.

Widespread action is needed to reverse current trends – and we all need to take responsibility for what we are feeding young bodies and minds.

The class involves 100% hands-on practical cooking in a small, supervised group, combined with teaching of up-to-date information and research findings on the effects of diet on health. Clear, easy-to-follow presentations and handouts are provided with plenty of opportunity for questions and discussion.

Scientists in Taiwan have published a paper in the February 2009 edition of the Journal of Agricultural and Food Chemistry indicating that an enzyme, nattokinase, which is found in a fermented soybean product called natto, has powerful ability in lab experiments to prevent formation of the clumps of tangled protein (amyloid fibrils) observed in Alzheimer’s disease.

More than 20 unrelated proteins can form amyloid fibrils in the body, which are related to various diseases, such as Alzheimer’s disease, prion disease, and systematic amyloidosis. Enhancing amyloid clearance is one of the targets of the therapy of these amyloid-related diseases. Although there is debate on whether the toxicity is due to amyloids or their precursors, research on the degradation of amyloids may shed light on the prevention or alleviation of these diseases.

In this Taiwanese study, nattokinase degraded several kinds of amyloid fibrils suggesting its possible use in the treatment of amyloid-related diseases.

Natto is a traditional Japanese food made from fermented soybeans and is a popular breakfast dish. For some, natto is an acquired taste due to its powerful smell, strong flavour and sticky consistency.

Natto is made from soybeans, typically a special type called natto soybeans. Smaller beans are preferred as the fermentation can progress to the centre of the bean more easily. The beans are washed and soaked in water for 12 to 20 hours, which causes the beans to swell. Next, the soybeans are steamed for 6 hours, although a pressure cooker can be used to reduce the time. The beans are then mixed with the bacterium Bacillus subtilis natto, known as natto-kin in Japanese. From this point on, care has to be taken to keep the ingredients away from impurities and other bacteria. The mixture is fermented at 40°C for up to 24 hours. Afterwards the natto is cooled, then aged in a refrigerator for up to one week to add stringiness. During the ageing process at a temperature of about 0°C, the bacteria develop spores, and enzymes break down the soybean protein into its constituent amino acids. For this reason, the high protein content of the soybean is in a very digestible form.

In addition to its high protein content, natto is rich in fibre, vitamin C, vitamin K, calcium, iron, potassium, phosphorus and magnesium. In common with other soybean products, natto contains significant quantities of the isoflavone phytonutrients including genistein and daidzein, which are believed to have cancer-protective properties.

Natto is believed to have numerous health benefits and there is some medical research to support this. The enzyme nattokinase is a serine protease which may reduce blood clotting by direct fibrinolysis of clots and inhibition of the plasma protein plasminogen activator inhibitor 1[i]. Clinical trials are needed to confirm laboratory studies. An extract from natto containing nattokinase is available as a dietary supplement.

Vitamin K, which is present in significant amounts in natto, is involved in the formation of calcium-binding groups in proteins, assisting the formation of bones and preventing osteoporosis. Vitamin K1 is found naturally in seaweed, liver and some vegetables, while vitamin K2 is found in fermented food products such as cheese and miso. Natto has very large amounts of vitamin K2, approximately 870 mg per 100 g natto.

Natto is reported to contain substantial levels of a natural product called pyrroloquinoline quinone, which has been shown to stimulate DNA synthesis in cultured human fibroblasts, modulate immune response, and reduce liver injury, cataract formation and lipid peroxidation[ii].

A study reported in 1996 suggested that natto may have benefits in reducing cholesterol levels in people whose cholesterol and triglyceride levels are high[iii].

In January 1997, a Japanese television programme called Revealed! Encyclopaedia of Living recommended two portions of natto per day as a means of losing weight in only two weeks. With the Japanese struggling with overweight and obesity this hit a nerve, and by lunchtime the next day national stocks of natto had sold out. Whilst it is the case that natto has a relatively low number of calories per g of protein and a high nutrient density, it will only contribute to weight loss if consumed as part of a healthy diet, high in whole grains, vegetables, fruits and unsaturated fats, and low in saturated fats, salt and sugar, combined with plenty of exercise.

The most popular way to eat natto is to put it in a small bowl, add a little soy sauce and some finely-chopped spring onion and/or some mustard, mix the ingredients together and serve on some steamed rice. Natto can also be added to miso soup to create a rich and nourishing dish, which smells a little like capuccino.